83-5-95 - Contents of impact report.
§ 83-5-95. Contents of impact report.
The report required under Section 83-5-93 or assessing the impact of a proposed mandate of health coverage shall include at the minimum and to the extent that information is available, the following:
(a) The social impact, including:
(i) The extent to which the treatment or service is generally utilized by a significant portion of the population;
(ii) The extent to which such insurance coverage is already generally available;
(iii) If coverage is not generally available, the extent to which the lack of coverage results in persons being unable to obtain necessary health care treatment;
(iv) If the coverage is not generally available, the extent to which the lack of coverage results in unreasonable financial hardship on those persons needing treatment;
(v) The level of public demand for the treatment or service;
(vi) The level of public demand for individual or group insurance coverage of the treatment or service;
(vii) The level of interest of collective bargaining organizations in negotiating privately for inclusion of this coverage in group contracts; and
(viii) The impact of indirect costs which are costs other than premiums and administrative costs, on the question of the costs and benefits of coverage.
(b) The financial impact, including:
(i) The extent to which insurance coverage of the kind proposed would increase or decrease the cost of the treatment or service;
(ii) The extent to which the proposed coverage might increase the use of the treatment or service;
(iii) The extent to which the mandated treatment or service might serve as an alternative for more expensive treatment or service;
(iv) The extent to which insurance coverage of the health care service or provider can be reasonably expected to increase or decrease the insurance premium and administrative expenses of policyholders; and
(v) The impact of this coverage on the total cost of health care.
(c) The medical efficacy, including:
(i) The contribution of the insurance coverage to the quality of patient care and the health status of the population, including the results of any research demonstrating the medical efficacy of the treatment or service compared to alternatives or not providing the treatment or service; and
(ii) If the legislation seeks to mandate coverage of an additional class of practitioners:
1. The results of any professionally acceptable research demonstrating the medical results achieved by the additional class of practitioners relative to those already covered; and
2. The methods of the appropriate professional organization that assure clinical proficiency.
(d) The effects of balancing the social, economic and medical efficacy considerations, including:
(i) The extent to which the need for coverage outweighs the cost of mandating the benefit for all insureds; and
(ii) The extent to which the problem of coverage may be solved by mandating the availability of the coverage as an option for insureds.
Sources: Laws, 1993, ch. 373, § 2, eff from and after passage (approved March 15, 1993).